Browsing by Author "Salvatierra Matzner, Isidora"

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    Association between GIP levels after glucose load and HMW adiponectin in normoglycemic women
    (2025) Salvatierra Matzner, Isidora; Parada, Javier; Cataldo Bascuñan, Luis Rodrigo; Galgani Fuentes, José; Alberti, Gigliola; Labayen, Idoia; Lorenzoni Santos, José Guillermo
    Background/Objectives: Glucose-dependent insulinotropic polypeptide (GIP) is secreted by enteroendocrine K cells in response to nutrient ingestion. The aims of this study are: 1) to evaluate the cross-sectional associations between plasma GIP change in response to an oral glucose challenge (as a surrogate of GIP secretion) with obesity-related anthropometric measurements, fasting inflammatory biomarkers, and fasting circulating adipokines. 2) to evaluate the feasibility of using postprandial plasma GIP as a biomarker of adiposity-related phenotypes in response to starchbased meals. Methods: Fifty normoglycemic women without obesity (19-32 years) were evaluated with an oral glucose tolerance test (OGTT). A feasibility study was conducted in a subset of eight women to estimate responses to starch-based meals (25 g of starch). Postprandial glycemic-related changes in plasma hormones/metabolites were assessed, as well as circulating adipokines and inflammatory biomarkers in fasting conditions. Results: The Incremental-GIP change after 2-hour OGTT was significantly associated with waist circumference (rho=0.34; P=0.02), fasting plasma TNFα (rho=0.54; P=0.0002), and white blood cell count (rho=0.39; P=0.008), but not with MCP-1, total adiponectin, leptin, or the free leptin index. A strong inverse association was found between incremental-GIP change and fasting plasma High-Molecular-Weight (HMW) Adiponectin (rho = -0.50; P = 0.0004), which remained significant after adjusting for age and body mass index. Conclusion: An inverse association was found between postprandial GIP levels and circulating HMW-adiponectin levels in humans. This research highlights the suitability of using postprandial plasma GIP as a biomarker for metabolic disturbances of increased adiposity, even in the absence of obesity.
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    Impact evaluation of an interdisciplinary approach to patients with chronic non-cancer pain in Chilean primary care
    (2025) Zamorano, Paula; Varela Yuraszeck, Teresita Ines; Salvatierra Matzner, Isidora; Tellez, Álvaro; Espinoza Sepúlveda, Manuel Antonio; Torres Riveros, Gustavo Andrés; Rodríguez, Victoria; Figueroa, María José; Rodríguez, Alejandro; Figueroa, Denisse; Silva, Leonardo; Salazar, Sheila; Lucero, Víctor; Suarez, Francisco
    Introduction Chronic non-cancer pain affects one-third of the global population. In Chile, its prevalence is estimated at 34%, surpassing the prevalence of diabetes mellitus and hypertension. Its high costs reveal that clinical treatment causes the greatest economic impact, followed by days of work absenteeism. Objective This study aims to evaluate the impact on resource consumption, quality of life, and pain perception in patients with CNCP, an interdisciplinary approach implemented in Chilean primary care public health. Methods A concurrent cohort study was conducted with patients aged 25 to 64 with chronic non-cancer musculoskeletal pain. The population studied was 698 patients receiving primary health services in centers with similar size and territorial proximity. The clinical intervention introduced patient-centered care, psychotherapy and physiotherapy from the perspective of the neuroscience of pain. The impact analysis was conducted using negative binomial regression models, generalized linear models, and ordered logistic regressions. Results Results show that the patients who were intervened increased the number of physician consultations at primary care (IRR: 1.56; 95% CI 1.30–1.87) and increased medication consumption (coef 2.38; 95% CI 2.10–2.67) compared to control patients. Intervened patients improved their quality of life (COEF 0.14; 95% CI 0.09–0.19), and pain perception was statistically significant. Despite the health system’s structural, cultural, and organizational barriers, the intervention was implemented and consolidated in daily operation, providing learnings for a further scale-up. Conclusion The study demonstrates that an interdisciplinary approach to chronic non-cancer pain management in Chilean primary care improves quality of life and pain perception while increasing healthcare resource use. Despite system barriers, the intervention was successfully implemented and sustained within patient-centered care. These findings highlight the need for resource reallocation to ensure long-term sustainability and scalability through the public health system.
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    Implementation of Integrated Care of Patients with Non-Cancer Chronic Pain in Chile: Advances and Challenges
    (UBIQUITY PRESS LTD, 2025) Zamorano Pichard, Paula Francisca; Varela Yuraszeck, Teresita Ines; Salvatierra Matzner, Isidora; Silva, Leonardo; Lucero, Victor; Figueroa, Denisse; Salazar, Sheila; Casas, Pia; Castro, Nidia; Montecinos, Pablo; Salinas, Francisco
    The impact of chronic non-cancer pain on individuals is complex, multidimensional, and with healthcare needs that challenge fragmented healthcare systems. There have been significant advances in generating scientific evidence, ministerial guidelines, and even laws in Chile. However, there is still a considerable gap that remains in the implementation in clinical practice. Despite this, clinical teams have implemented three pilot programs in different countries. This perspective discusses these pilots, their implementation process, acquired knowledge, and the challenge of advancing toward scaling up.
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    Performance of a national primary care chronic disease screening strategy in Chile: a mixed-methods analysis
    (2025-08-20) Zamorano, Paula; Varela Yuraszeck, Teresita Inés; Salvatierra Matzner, Isidora; Téllez, Álvaro; Martínez Pérez, Mayra Alicia; Ilabaca, Juan; Huidobro, Diego G.
    Introduction The continuous increase in chronic non-communicable diseases requires strengthening primary care preventive strategies. In Chile, preventive health screening is a national strategy focused on identifying adults with risk factors, including hypertension, diabetes, and dyslipidemia, among others. It is broadly implemented in primary care and has associated performance resources. Objective To evaluate the performance of Chile’s primary care preventive health screening for adults and describe healthcare professionals' perceptions regarding its implementation. Methods: A parallel convergent mixed-methods study was conducted. The quantitative component employed a retrospective cohort study to assess individuals between 15 and 64 years old who received a preventive health screening in primary care during 2023. Data analysis focused on access and waiting times of the screening pathways. The qualitative component consisted of an online survey to evaluate participants' perceptions of the screening pathways' performance. Results A total of 36,207 adult individuals received a preventive health screening during 2023, of which 61.5% were reported as completed. Screenings with the highest completion rates (between 99% and 80.1%) were those performed during the check-up day: high blood pressure, overweight and obesity, alcohol consumption, and smoking. Access to the second and third steps declines abruptly, with rates between 61.4% and 39.3%, including breast and cervical cancer screenings. The lowest access was to dyslipidemia and diabetes mellitus type two screening. Mean waiting times range from 16 to 179 days. The shortest times were from the screening to the first measure of the high blood pressure study and the pap smear test (16 and 18 days, respectively). The longest times were for diagnostic cardiovascular diseases (129 to 179 mean days). Qualitative findings identified that providers perceived that individuals are frequently lost when the screening pathway requires multiple steps, and highlighted the need to develop screening pathway protocols and implement strategies to manage the screening pathway proactively. Conclusion This is the first evaluation of Chile’s preventive health screening, demonstrating high implementation but dramatically low completion rates of diagnostic actions after the screening. The policy urgently needs to ensure active follow-up throughout the diagnostic pathway, which can lead to early diagnosis and prevent avoidable complications of cardiovascular disease and cancer.